Provider Demographics
NPI:1497210926
Name:COLON, YVETTE (MSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 OAKBROOK DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9493
Mailing Address - Country:US
Mailing Address - Phone:734-961-7113
Mailing Address - Fax:888-965-5133
Practice Address - Street 1:124 PEARL ST STE 503
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2663
Practice Address - Country:US
Practice Address - Phone:734-985-0265
Practice Address - Fax:888-965-5133
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010898881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical